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Amniotic Fluid Embolism - pathogenesis and clinical manifestations.

Amniotic Fluid Embolism.
      It refers to "the presence of amniotic fluid in the blood vessels of the mother. The amniotic fluid contains squamous epithelium of fetal skin, lanugo hair, fat from vernix caseosa and mucin from fetal GIT.

It commonly occurs in older multiparous patients who have undergone emotionally stressed labour.

Amniotic fluid enters the mother's circulation through endocervical veins, uteroplacental sites or laceration of uterus or cervix. Amniotic fluid contains;

  1. vasoactive substances for example prostaglandins that cause pulmonary vasoconstriction. pulmonary vasoconstriction decreases the capability of lungs and patient will show the signs like cyanosis, tachypnea and dyspnea.
  2. Thrombogenic factors that induce intravascular coagulation, leading to Disseminated intravascular coagulation and its complications ( e.g haemorrhages and acute renal failure)
Clinical Manifestations:

Sudden onset of dyspnea, cyanosis, collapse and haemorrhage.
Convulsion followed by comma. 

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